Cost effectiveness of OptiMal (R) rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

Background: In areas with limited structure in place for microscopy diagnosis, rapid diagnostic tests (RDT) have been demonstrated to be effective. Method: The cost-effectiveness of the Optimal (R) and thick smear microscopy was estimated and compared. Data were collected on remote areas of 12 municipalities in the Brazilian Amazon. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, hospitalization records, primary data collected from the municipalities, and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2006. The results were expressed in costs per adequately diagnosed cases in 2006 U. S. dollars. Sensitivity analysis was performed considering key model parameters. Results: In the case base scenario, considering 92% and 95% sensitivity for thick smear microscopy to Plasmodium falciparum and Plasmodium vivax, respectively, and 100% specificity for both species, thick smear microscopy is more costly and more effective, with an incremental cost estimated at US$ 549.9 per adequately diagnosed case. In sensitivity analysis, when sensitivity and specificity of microscopy for P. vivax were 0.90 and 0.98, respectively, and when its sensitivity for P. falciparum was 0.83, the RDT was more cost-effective than microscopy. Conclusion: Microscopy is more cost-effective than OptiMal (R) in these remote areas if high accuracy of microscopy is maintained in the field. Decision regarding use of rapid tests for diagnosis of malaria in these areas depends on current microscopy accuracy in the field.

Quantum reflection: The invisible quantum barrier

We construct an invisible quantum barrier which represents the phenomenon of quantum reflection using available data on atom-wall and Bose-Einstein-condensate-wall reflection. We use the Abel equation to invert the data. The resulting invisible quantum barrier is double valued in both axes. We study this invisible barrier in the case of atom and Bose-Einstein condensate (BEC) reflection from a solid silicon surface. A time-dependent, one-spatial-dimension Gross-Pitaevskii equation is solved for the BEC case. We found that the BEC behaves very similarly to the single atom except for size effects, which manifest themselves in a maximum in the reflectivity at small distances from the wall. The effect of the atom-atom interaction on the BEC reflection and correspondingly on the invisible barrier is found to be appreciable at low velocities and comparable to the finite-size effect. The trapping of an ultracold atom or BEC between two walls is discussed.

Increase in the magnitude of the energy barrier distribution in Ni nanoparticles due to dipolar interactions

The energy barrier distribution E(b) of five samples with different concentrations x of Ni nanoparticles using scaling plots from ac magnetic susceptibility data has been determined. The scaling of the imaginary part of the susceptibility chi""(v, T) versus T ln (iota t/tau(0)) remains valid for all samples, which display Ni nanoparticles with similar shape and size. The mean value < E(b)> increases appreciably with increasing x, or more appropriately with increasing dipolar interactions between Ni nanoparticles. We argue that such an increase in < E(b)> constitutes a powerful tool for quality control in magnetic recording media technology where the dipolar interaction plays an important role. (c) 2011 American Institute of Physics. [doi: 10.1063/1.3533911]

Barrier-free substitutional doping of graphene sheets with boron atoms: Ab initio calculations

Using ab initio methods, we propose a simple and effective way to substitutionally dope graphene sheets with boron. The method consists of selectively exposing each side of the graphene sheet to different elements. We first expose one side of the membrane to boron while the other side is exposed to nitrogen. Proceeding this way, the B atoms will be spontaneously incorporated into the graphene membrane without any activation barrier. In a second step, the system should be exposed to a H-rich environment, which will remove the CN radical from the layer and form HCN, leading to a perfect substitutional doping.

Quasi-elastic barrier distribution of the (17)O+(64)Zn system and the derivation of the (17)O nuclear matter diffuseness

The quasi-elastic excitation function for the (17)O+(64)Zn system was measured at energies near and below the Coulomb barrier, at the backward angle theta(lab) = 161 degrees. The corresponding quasi-elastic barrier distribution was derived. The excitation function for the neutron stripping reactions was also measured, at the same angle and energies, and the experimental values of the spectroscopic factors were deduced by fitting the data. A reasonably good agreement was obtained between the experimental quasi-elastic barrier distribution with the coupled-channel calculations including a very large number of channels. Of the channels investigated, three dominated the coupling matrix: two inelastic channels, (64)Zn(2(1)(+)) and (17)O(1/(+)(2)), and one-neutron transfer channel, particularly the first one. On the other hand, a very good agreement is obtained when we use a nuclear diffuseness for the (17)O nucleus larger than the one for (16)O. We verify that quasi-elastic barrier distribution is a sensitive tool for determining nuclear matter diffuseness.

Near-Barrier Fusion of the (8)B+(58)Ni Proton-Halo System

Fusion cross sections were measured for the exotic proton-halo nucleus (8)B incident on a (58)Ni target at several energies near the Coulomb barrier. This is the first experiment to report on the fusion of a protonhalo nucleus. The resulting excitation function shows a striking enhancement with respect to expectations for normal projectiles. Evidence is presented that the sum of the fusion and breakup yields saturates the total reaction cross section.

Barrier distributions for weakly bound systems

We discuss the use of reduced fusion cross sections in the derivation of fusion barrier distributions. We show that the elimination of static effects associated with system sizes and optical potentials obtained by the recently introduced fusion functions can be extended to barrier distributions. This can be a useful tool for systematic studies of breakup coupling effects in fusion processes.

Breakup coupling effects on near-barrier quasi-elastic scattering of (6,7)Li on (144)Sm

Excitation functions of quasi-elastic scattering at backward angles have been measured for the (6,7)Li + (144)Sm systems at near-barrier energies, and fusion barrier distributions have been extracted from the first derivatives of the experimental cross sections with respect to the bombarding energies. The data have been analyzed in the framework of continuum discretized coupled-channel calculations, and the results have been obtained in terms of the influence exerted by the inclusion of different reaction channels, with emphasis on the role played by the projectile breakup.

Reaction cross sections for (8)B, (7)Be, and (6)Li+(58)Ni near the Coulomb barrier: Proton-halo effects

Elastic scattering of (8)B, (7)Be, and (6)Li on a (58)Ni target has been measured at energies near the Coulomb barrier. Optical-model fits were made to the experimental angular distributions, and total reaction cross sections were deduced. A comparison with other systems provides striking evidence for proton-halo effects on (8)B reactions. As opposed to the situation for the neutron-halo nucleus (6)He, for which particle transfer dominates, the ""extra"" cross section observed for (8)B appears to result entirely from projectile breakup.

Near-barrier quasielastic scattering as a sensitive tool to derive nuclear matter diffuseness

Quasielastic excitation functions for the (16,18)O + (60)Ni systems were measured at energies near and below the Coulomb barrier, at the backward angle theta(LAB) = 161 degrees. The corresponding quasielastic barrier distributions were derived. The data were compared with predictions from coupled channel calculations using a double-folding potential as a bare potential. For the (16)O-induced scattering, good agreement was obtained for the barrier distribution by using the projectile default nuclear matter diffuseness obtained from the Sao Paulo potential systematic, that is, 0.56 fm. However, for the (18)O-induced scattering, good agreement was obtained only when the projectile nuclear matter diffuseness was changed to 0.62 fm. Therefore, in this paper we show how near-barrier quasielastic scattering can be used as a sensitive tool to derive nuclear matter diffuseness.

Density-functional description of superconducting and magnetic proximity effects across a tunneling barrier

A density-functional formalism for superconductivity and magnetism is presented. The resulting relations unify previously derived Kohn-Sham equations for superconductors and for noncollinear magnetism. The formalism, which discriminates Cooper-pair singlets from triplets, is applied to two quantum liquids coupled by tunneling through a barrier. An exact expression is derived, relating the eigenstates and eigenvalues of the Kohn-Sham equations, unperturbed by tunneling, on one side of the barrier to the proximity-induced ordering potential on the other.

Cost-effectiveness of Sick Leave Policies for Health Care Workers with Influenza-like Illness, Brazil, 2009

We describe the effect of influenza-like illness (ILI) during the outbreak of pandemic (H1N1) 2009 on health care worker (HCW) absenteeism and compare the effectiveness and cost of 2 sick leave policies for HCWs with suspected influenza. We assessed initial 2-day sick leaves plus reassessment until the HOW was asymptomatic (2-day + reassessment policy), and initial 7-day sick leaves (7-day policy). Sick leaves peaked in August 2009: 3% of the workforce received leave for ILI. Costs during May October reached R$798,051.87 (approximate to US $443,362). The 7-day policy led to a higher monthly rate of sick leave days per 100 HCWs than did the 2-day + reassessment policy (8.72 vs. 3.47 days/100 HCWs; p<0.0001) and resulted in higher costs (US $609 vs. US $1,128 per HCW on leave). ILI affected HCW absenteeism. The 7-day policy was more costly and not more effective in preventing transmission to patients than the 2-day + reassessment policy.

Chronostratigraphy and radiocarbon age inversion in the Holocene regressive barrier of Parana, southern Brazil

Twenty-two (14)C datings were performed at the central sector of the Parana coast to define Holocene regressive barrier evolution. The barrier Pleistocene substratum was ascribed an age between 40400 and 30000 yr BP, but it can also represent the penultimate sea level highstand during marine isotope stage 5e. The Holocene barrier samples provided ages between 8542-8279 and 2987-2751 cal yr BP, and showed at least six age inversions that were related to age differences between in situ or low-distance transported shells or trunk fragments, and high-distance transported vegetal debris, wood fragments and organic matter samples. The regressive Holocene barrier age was 4402-4135 cal yr BP near the base, and 2987-2751 cal yr BP near the top. Most of the vegetal remains were transported by ebb tidal currents from the estuaries to the inner shelf below wave base level during the mid-Holocene highstand; they were transported onshore by storm waves and littoral currents during the sea level lowering after the sea level maximum, and were deposited mainly as middle shoreface swaley cross-stratification facies. (C) 2008 Published by Elsevier B.V.

Effectiveness of local anaesthetics with and without vasoconstrictors for perineal repair during spontaneous delivery: Double-blind randomised controlled trial

Objective: to investigate the use of local anaesthetics, in the presence or absence of vasoconstrictors, for perineal repair during spontaneous delivery. Design: double-blind, randomised-controlled trial. Setting: a birth centre, in the city of Sao Paulo, Brazil. Participants: from June to December 2004, a total of 96 women were allocated into three groups (first-degree perineal lacerations, second-degree perineal lacerations or episiotomy), and treated with local anaesthesia (1% lidocaine or 1% lidocaine with epinephrine) (n = 16 per treatment per group). Interventions: an initial local infiltration of the anaesthetic solution was given so that episiotomy could be carried out (5 ml) and to suture spontaneous lacerations (1 ml), followed by repeated doses (1 ml) until pain was completely inhibited. Measurements and findings: the main outcome measurement was the volume of anaesthetic used during episiotomy and perineal suture. Our data suggest that the concomitant use of the vasoconstrictor resulted in a significantly lower average volume used in the treatment of first-degree (1 ml, 95% confidence interval (0) 0.4-1.6) and second-degree (3.7 ml, 95% CI 1.6-5.8) lacerations (p = 0.002 and 0.001, respectively). A 0.3 ml (95% CI 1.5-2.1) average decrease in anaesthetic volume was observed with episiotomy (p = 0.724). The maximum volume of anaesthetic used with and without vasoconstrictor was 1-2 ml in 95% and 3-4 ml in 50% of first-degree lacerations, respectively, and 1-6 ml in 88% and 7-15 ml in 81% of second-degree lacerations, respectively. For episiotomy, the maximum dose was 15 ml, regardless of anaesthetic solution used. Key conclusions: our data confirm the hypothesis that the use of anaesthetics in conjunction with vasoconstrictors is more effective than anaesthetics alone in the repair of perineal lacerations, but not for episiotomy. (C) 2007 Elsevier Ltd. All rights reserved.

A Cost-Benefit Analysis on Modulation Formats for 40-Gb/s Optical Communication Systems

This article discusses possible approaches for optical network capacity upgrade by considering the use of different modulation formats at 40 Gb/s. First, a performance evaluation is carried out regarding tolerance to three impairments: spectral narrowing due to filter cascading, chromatic dispersion, and self-phase modulation. Next, a cost-benefit analysis is conducted, considering the specific optoelectronic components required for the optical transmitter/receiver configuration of each format.